Macey M G, McCarthy D A, Trivedi U R, Venn G E, Chambers D J, Brown K A
Department of Haematology, Royal London Hospital, UK.
Perfusion. 1997 Sep;12(5):293-301. doi: 10.1177/026765919701200504.
The purpose of this study was to determine whether adhesion molecules and markers of cell activation were preferentially increased on blood neutrophils during cardiopulmonary bypass (CPB) and whether such effects were influenced by the use of a roller pump or a centrifugal pump. Forty-six patients undergoing open heart surgery were randomly allocated into either the roller or centrifugal groups. Blood (1 ml volumes) was removed from arterial and venous lines immediately before and 1 h after the start of bypass. Whole blood samples were immunolabelled and flow cytometry used to measure the distribution and expression of the adhesion molecules CD11b, CD18, CD62L on neutrophils, monocytes and lymphocytes, in addition to CD64 on neutrophils and monocytes, and CD14 on monocytes. The expression of CD11b was significantly enhanced on neutrophils in arterial and venous samples from both the roller pump (mean 84% and 100% increase, respectively; p < 0.001) and centrifugal pump (mean 74% and 73% increase, respectively; p < 0.001) groups. Neutrophil L-selectin expression increased to a small but significant extent in arterial and venous samples from the centrifugal pump group (mean 16% increase; p < 0.001) and in venous samples from the roller pump group (mean 10% increase; p < 0.01). Neither the percentage of neutrophils bearing CD11b/CD18, CD62L and CD64, nor the expression of adhesion molecules on lymphocytes and monocytes were modified by 1 h of bypass. These results suggest that patients subjected to CPB with roller or centrifugal pumps are equally at risk to neutrophil activation that could lead to increased interaction of these cells with blood vessel walls.
本研究的目的是确定在体外循环（CPB）期间血液中性粒细胞上的黏附分子和细胞活化标志物是否会优先增加，以及这些效应是否受到滚压泵或离心泵使用的影响。46例接受心脏直视手术的患者被随机分为滚压泵组或离心泵组。在体外循环开始前和开始后1小时，立即从动脉和静脉管路中采集1毫升血液样本。对全血样本进行免疫标记，并使用流式细胞术测量中性粒细胞、单核细胞和淋巴细胞上黏附分子CD11b、CD18、CD62L的分布和表达，以及中性粒细胞和单核细胞上的CD64和单核细胞上的CD14。滚压泵组（平均分别增加84%和100%；p<0.001）和离心泵组（平均分别增加74%和73%；p<0.001）的动脉和静脉样本中的中性粒细胞上CD11b的表达均显著增强。离心泵组动脉和静脉样本（平均增加16%；p<0.001）以及滚压泵组静脉样本（平均增加10%；p<0.01）中，中性粒细胞L-选择素表达有小幅但显著的增加。体外循环1小时对携带CD11b/CD18、CD62L和CD64的中性粒细胞百分比以及淋巴细胞和单核细胞上黏附分子的表达均无影响。这些结果表明，使用滚压泵或离心泵进行体外循环的患者，中性粒细胞活化的风险相同，而中性粒细胞活化可能导致这些细胞与血管壁的相互作用增加。
